An Overview of Integrated Health-Nutrition Service and Characteristics of Volunteer Health Workers: A Study in West Java, Indonesia

  • Ali Khomsan Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, 16680, Indonesia
  • Mira Dewi Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, 16680, Indonesia
  • Karina Rahmadia Ekawidyani Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, 16680, Indonesia
Keywords: Volunteer health workers, Food Habit, Food Security, Nutrition Education, Posyandu


Background: The stunting problem is still a concern and priority for WHO and countries in the world, including Indonesia. The Integrated Health-Nutrition Service in Indonesia (called Posyandu) is the closest unit to reach the community through nutrition education and health services. This study aims to analyze volunteer health workers’ characteristics and obtain an overview of Posyandu services during the Covid-19 pandemic. This study was conducted in Cirebon Regency, West Java, Indonesia. The study design used was cross-sectional. The respondents were selected purposively. The collected data includes the age, education level, working period, incentive received, participation in nutrition training, the procedure of Posyandu during the pandemic, nutritional knowledge and attitude, food habits, and household food security. The study results showed that most of the volunteer health workers aged 26-35 years with educational level from primary to high school graduates. The mean of working period was four years and receiving incentive US$2/month. In addition, most of the Posyandu were not in operation due to the Covid-19 pandemic conditions. Nutritional knowledge and attitudes of volunteer health workers were mostly high. More than half of the volunteer health workers’ households were food insecure. Conclusion: the educational levels and nutritional knowledge of Posyandu’s volunteer health workers were high, but their food security were still low. During the Covid-19 pandemic, Posyandu was not in operation. Alternative solutions to support household food security could be through utilizing the home garden for plant crops.


. Ministry of Health Republic of Indonesia, “National health research report 2018,” Jakarta (ID), 2018.

. E. A. Frongillo, “Symposium: causes and etiology of stunting: introduction,” J. Nutr., vol. 129, no. 2S Suppl, pp. 529S-530S, 1999.

. R. Ediwiyanti, D. Koestiono, and B. Setiawan, “Analysis of household food security: case study at implementation of village with food self-sufficient program in Oro Bulu Village Rembang District Pasuruan Regency,” Agrise, vol. XV, no. 2, pp. 85–83, 2015.

. Ministry of Health Republic of Indonesia and Central of Development Operational Working Group Posyandu (Pokjanal Posyandu), “Curriculum and training modules for posyandu volunteer health workers,” Jakarta (ID), 2012.

. D. Evita, A. Mursyid, and T. Siswanti, “Improved knowledge, skills, and compliance of puskesmas volunteer health workers in implementing growth monitoring standard of underfive in Bitung City,” J. Gizi dan Diet. Indones., vol. 1, no. 1, pp. 15–21, 2013.

. G. Namazzi et al., “Working with community health workers to improve maternal and newborn health outcomes: implementation and scale-up lessons from eastern Uganda,” Glob. Health Action, vol. 10, no. sup4, p. 1345495, Aug. 2017, doi: 10.1080/16549716.2017.1345495.

. C. A. J. Navarro, G. M. P. Gironella, and M. S. E. Ignacio, “Association of household food security status with mother/caregiver-child Pair’s nutritional status using HFIAS and FCS,” Philipp. J. Sci., vol. 147, no. 3, pp. 493–501, 2018.

. C. R. Ashari, A. Khomsan, and Y. F. Baliwati, “HFIAS (Household Food Insecurity Access Scale) validation to measure household food security,” Penelit. Gizi dan Makanan (The J. Nutr. Food Res., vol. 42, no. 1, pp. 11–20, 2019, doi: 10.22435/pgm.v42i1.2417.

. N. Salarkia, M. Abdollahi, M. Amini, and T. R. Neyestani, “An adapted household food insecurity access scale is a valid tool as a proxy measure of food access for use in urban Iran,” Food Secur., vol. 6, no. 2, pp. 275–282, Feb. 2014, doi: 10.1007/s12571-014-0335-7.

. Ministry of Health Republic of Indonesia, “Implementation of primary health care in Indonesia,” 2011. (accessed Nov. 26, 2020).

. Ministry of Health Republic of Indonesia, “Indonesia’s health profile in 2019,” Jakarta (ID), 2018.

. Ministry of Health Republic of Indonesia, “General guidelines for posyandu management,” Jakarta (ID), 2018.

. I. Afifa, “The volunteer health workers performa in stunting prevention: rule of working duration as volunteer health workers, knowledge, and motivation,” J. Kedokt. Brawijaya, vol. 30, no. 4, pp. 336–341, 2019.

. U. Bidayati, “Commitment , motivation, and performance of posyandu cadres,” Adv. Intelegent Syst. Res., vol. 131, no. International Conference on Organizational Innovation (ICOI 2017), pp. 93–97, 2017, doi: 10.2991/icoi-17.2017.27.

. R. Wirapuspita, “Incentives and performance of posyandu volunteer health workers,” J. Kesehat. Masy., vol. 9, no. 1, pp. 58–65, 2013, doi: 10.15294/kemas.v9i1.2831.

. L. McIntyre, A. C. Bartoo, and J. C. H. Emery, “When working is not enough: Food insecurity in the Canadian labour force,” Public Health Nutr., vol. 17, no. 1, pp. 49–57, 2012, doi: 10.1017/S1368980012004053.

. F. Susanto, M. Claramita, and S. Handayani, “Peran kader posyandu dalam pemberdayaan masyarakat Bintan” J. Community Med. Public Heal., pp. 33–42, 2017.

. Ministry of Health Republic of Indonesia, “Tehcnical instructions for immunization services during Covid-19 Pandemic,” Jakarta (ID), 2020.

. N. G. T. Mushonga, H. A. Mujuru, L. K. Nyanga, S. Nyagura, N. Musaka, and R. Dembah, “Parental knowledge, attitudes and practices regarding overweight among preschool children in rural Zimbabwe,” African J. Food, Agric. Nutr. Dev., vol. 17, no. 4, pp. 12775–12790, 2017, doi: 10.18697/ajfand.80.16480.

. H. B. Perry, R. Zulliger, and M. M. Rogers, “Community health workers in low-, middle-, and high-income countries: An overview of their history, recent evolution, and current effectiveness,” Annu. Rev. Public Health, vol. 35, pp. 399–421, 2014, doi: 10.1146/annurev-publhealth-032013-182354.

. F. Perdana, S. Madanijah, and I. Ekayanti, “Pengembangan media edukasi gizi berbasis android dan website serta pengaruhnya terhadap perilaku tentang gizi seimbang siswa sekolah dasar,” J. Gizi dan Pangan, vol. 12, no. 3, pp. 169–178, 2017, doi: 10.25182/jgp.2017.12.3.169-178.

. M. Walton et al., “Implementing a one health village volunteer programme in West Sulawesi, Indonesia: A pilot study,” Glob. Public Health, vol. 0, no. 0, pp. 1–16, 2020, doi: 10.1080/17441692.2020.1836247.

. S. Azagba and M. F. Sharaf, “Disparities in the frequency of fruit and vegetable consumption by socio-demographic and lifestyle characteristics in Canada,” Nutr. J., vol. 10, no. 118, pp. 1–8, 2011, doi: 10.1016/s0002-8223(99)00080-2.

. M. Ariani, A. Suryana, S. H. Suhartini, and H. P. Saliem, “Keragaan Konsumsi Pangan Hewani Berdasarkan Wilayah dan Pendapatan di Tingkat Rumah Tangga,” Anal. Kebijak. Pertan., vol. 16, no. 2, p. 147, Dec. 2018, doi: 10.21082/akp.v16n2.2018.147-163.

. Firmansyah, S. Oktavilia, R. Prayogi, and R. Abdulah, “Indonesian fish consumption: An analysis of dynamic panel regression model,” IOP Conf. Ser. Earth Environ. Sci., vol. 246, no. 1, pp. 1–4, 2019, doi: 10.1088/1755-1315/246/1/012005.

. T. Q. Trung et al., “Factors influencing milk consumption of rural households in Northern Vietnam,” Greener J. Bus. Manag. Stud., vol. 4, no. 2, pp. 31–40, 2014, doi: 10.15580/gjbms.2014.2.031714148.

. Food and Agriculture Organization, “Update on COVID-19 and its impact on food security and nutrition, and food systems,” Rome, 2020.

. W. Nkomoki, M. Bavorová, and J. Banout, “Factors associated with household food security in Zambia,” Sustain., vol. 11, no. 9, pp. 1–18, 2019, doi: 10.3390/su11092715.

. I. Tanziha and E. Herdiana, “Path analysis: determinant factors of household food security in Lebak District, Banten Province,” J. Gizi dan Pangan, vol. 4, no. 2, pp. 106–115, 2009.

. A. Azwardi, H. F. Widyasthika, R. C. Saleh, and N. Adnan, “Household Food Security: Evidence From South Sumatera,” Jejak, vol. 12, no. 2, pp. 446–465, 2019, doi: 10.15294/jejak.v12i2.20264.

. N. Purnasari, T. Juwitangtyas, and I. Sabarisman, “Household food security during Covid-19 pandemic in Daerah Istimewa Yogyakarta, Indonesia,” Sustinere J. Environ. Sustain., vol. 4, no. 2, pp. 132–143, 2020, doi: 10.22515/sustinere.jes.v4i2.118.

. F. M. Anggrayni, D. R. Andrias, and M. Adriani, “Ketahanan pangan dan coping strategy rumah tangga urban farming pertanian dan perikanan Kota Surabaya,” Media Gizi Indones., vol. 10, no. 2, pp. 173–178, 2015.

. T. B. Purwantini, S. Saptana, and S. Suharyono, “Sustainable reserve food garden program in Pacitan Regency: Its impacts and prospect.,” Anal. Kebijak. Pertan., vol. 10, no. 3, pp. 239–256, 2012, doi: 10.21082/akp.v10n3.2012.239-256.